Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Vaccine. 2011 Nov 8;29(48):8855-62. doi: 10.1016/j.vaccine.2011.09.095. Epub 2011 Oct 6.
We assessed the immunogenicity of the paediatric dose of Epaxal(®) (0.25 mL) and the degrees of seroprotection achieved with the standard dose (0.5 mL) of Epaxal(®) or a dose of Havrix(®) Junior, in children in an open, randomised, controlled, multi-centre, parallel-group study conducted at 2 Chilean study centres. 360 healthy children and adolescents 12 months to <17 years of age not previously vaccinated against hepatitis A were enrolled. Subjects were randomised 2:2:1 to be vaccinated with either Epaxal(®) 0.25 mL [n=146], Epaxal(®) 0.5 mL [n=142] or Havrix(®) Junior [n=72] intramuscularly on Day 1 and after 6 months (26 weeks±14 days). Primary end point was the proportion of subjects seroprotected (anti-HAV antibody concentration ≥10 mIU/mL) in the ATP population at Month 1. All vaccines elicited high seroprotection rates at Month 1: 95.7% with Epaxal(®) 0.25 mL, 99.3% with Epaxal(®) 0.5 mL and 94.0% with Havrix(®) Junior. After the booster vaccination, all subjects demonstrated 100% seroprotection with all vaccines. Antibody concentrations were similarly high in all age groups. The paediatric presentation achieved antibody concentrations similar to those achieved with the 0.5 mL dose across the entire age range, and there were no differences across the range of body weights from 9.0 kg to 82.7 kg. All study vaccines were well tolerated and there were no AEs leading to discontinuation. Thus, the paediatric 0.25 mL dose of Epaxal(®) fulfilled the primary objective of showing non-inferiority to the adult 0.5 mL dose and to Havrix(®) Junior, in terms of seroprotection rates achieved. The results show the paediatric dose of Epaxal(®) to be an attractive option when conducting childhood-vaccination programmes.
我们评估了 Epaxal(®)(0.25 毫升)小儿剂量的免疫原性,以及 Epaxal(®)(0.5 毫升)标准剂量或 Havrix(®) Junior 剂量在智利 2 个研究中心进行的一项开放性、随机、对照、多中心、平行组研究中达到的血清保护程度。共纳入 360 名 12 个月至<17 岁未接种过甲型肝炎疫苗的健康儿童和青少年。受试者按照 2:2:1 的比例随机分为三组,分别接受 Epaxal(®)0.25 毫升[n=146]、Epaxal(®)0.5 毫升[n=142]或 Havrix(®)Junior[n=72]肌内注射,第 1 天和第 6 个月(26 周±14 天)。主要终点是在 ATP 人群中,第 1 个月时血清保护率(抗-HAV 抗体浓度≥10mIU/mL)的比例。所有疫苗在第 1 个月均产生高血清保护率:Epaxal(®)0.25 毫升组为 95.7%,Epaxal(®)0.5 毫升组为 99.3%,Havrix(®)Junior 组为 94.0%。加强免疫后,所有疫苗在所有年龄组均达到 100%的血清保护率。所有年龄组的抗体浓度均较高。小儿剂量的表现达到了与整个年龄范围 0.5 毫升剂量相似的抗体浓度,体重从 9.0 公斤到 82.7 公斤的范围内没有差异。所有研究疫苗均具有良好的耐受性,没有因不良事件而停药的情况。因此,Epaxal(®)小儿 0.25 毫升剂量在血清保护率方面,与成人 0.5 毫升剂量和 Havrix(®)Junior 相当,达到了非劣效性主要目标。结果表明,在开展儿童疫苗接种计划时,Epaxal(®)小儿剂量是一种有吸引力的选择。